title: Characterization of orgasmic difficulties by women: focus group evaluation.
abstract: BACKGROUND
  Female orgasmic disorder (FOD) is the second most prevalent sexual disorder in women. According to the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV-TR), the term "marked distress" is central to the diagnosis of FOD. In practice, the term "distress" for use as a criterion for a clinical diagnosis is a medical construct and may not correlate with the language used by women with FOD to describe what they are experiencing.
  
  
  OBJECTIVE
  The objective of this study was to explore the terminology used by women to describe their feeling associated with difficulties in achieving orgasm.
  
  
  METHODS
  Women experiencing difficulties in achieving orgasm were invited to participate in a focus group. The focus groups included a characterization, picture sort and language exploration exercise and completing the Female Sexual Distress Scale-Desire, Arousal, Orgasm (FSDS-DAO) to determine the impact and emotional associations of decreased/lack of orgasms.
  
  
  METHODS
  Patient reported terminology for characterization of their FOD, and validity of question 15 of FSDS-DAO.
  
  
  RESULTS
  Sixty-seven percent (44/66) of the women used the word "frustrated" when asked, "What one word would you use to describe your orgasm difficulties?" In the language exploration exercise, the most common term used to describe emotions associated with decreased orgasm was "frustration." Responses (0 = never to 4 = always) to question 15 (frustrated by problems with orgasm) of the FSDS-DAO, ranged from 1 to 4 (mean 3.0) indicating that women were very frustrated.
  
  
  CONCLUSIONS
  The term "frustrated" was the most relevant and common emotion women feel when they have difficulties in achieving orgasm. Additionally, the women consistently supported the content validity of question 15 of the FSDS-DAO. Despite the use of the term "distress" in the DSM-IV-TR criteria for FOD, the term reflects the medical construct required to become a sexual dysfunction and does not appear to be an accurate representation of most women's feelings of orgasm difficulties.
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, USA.
authors.forename: Sheryl A
authors.initials: SA
authors.lastname: Kingsberg
authors.forename: Natalia
authors.initials: N
authors.lastname: Tkachenko
authors.forename: Johna
authors.initials: J
authors.lastname: Lucas
authors.forename: Amy
authors.initials: A
authors.lastname: Burbrink
authors.forename: Wayne
authors.initials: W
authors.lastname: Kreppner
authors.forename: Jodi B
authors.initials: JB
authors.lastname: Dickstein
mesh_terms: D000328:Adult; D001143:Arousal; D005260:Female; D017144:Focus Groups; D005639:Frustration; D006801:Humans; D008875:Middle Aged; D009519:New York City; D009820:Ohio; D009948:Orgasm; D012725:Sexual Behavior; D020018:Sexual Dysfunctions, Psychological / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D009626:Terminology as Topic; D055815:Young Adult
keywords: Distress; Female Orgasmic Disorder; Focus Group